Why the study?
The underlying mechanisms and specific risk factors for the occurrence of QRS fragmentation in patients with STEMI undergoing PCI had not been analyzed.
What are the clinical and biochemical risk factors associated with the occurrence of QRS fragmentation in patients with STEMI undergoing primary PCI?
What are the clinical and biochemical risk factors associated with the occurrence of QRS fragmentation in patients with STEMI undergoing primary PCI?
CRP levels on admission are independently associated with the presence of QRS fragmentation in STEMI patients undergoing primary PCI, suggesting fQRS may serve as a marker for extensive inflammation.
Should not change STEMI practice; hypothesis-generating for fQRS as inflammation marker.
Background and Objectives: Despite modern therapy algorithms, ST-elevation myocardial infarction (STEMI) substantially contributes to cardiovascular morbidity and mortality worldwide. Early Risk assessment is crucial to guide therapy allocation, especially in countries with limited healthcare resources. Electrocardiographic parameters such as QRS fragmentation (fQRS) evolved as an important prognostic marker. The underlying mechanisms and specific risk factors for the occurrence of fQRS in patients with STEMI undergoing PCI have not been analyzed yet. Materials and Methods: Between 09/2020 and 06/2021, out of 179 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (pPCI), 122 patients were included in this study. The occurrence of fQRS was analyzed and correlated to clinical as well as biochemical parameters. Results: In this population, the fQRS pattern was present in 33.6% (n = 41) of patients. Besides gender, no statistically significant differences in baseline characteristics or comorbidities were observed between the two groups. In univariable logistic regression analysis, both glomerular filtration rate (GFR) (p = 0.050) and C-reactive protein (CRP) (p = 0.014) were significantly associated with the presence of fQRS. However, in the multivariable logistic regression model, only CRP levels on admission remained independently associated with fQRS (OR = 3.44, 95% CI: 1.95; 6.05), (p = 0.029). Conclusions: In this analysis, a correlation between fQRS and CRP levels in patients with STEMI undergoing pPCI could be demonstrated. Consequently, fQRS might serve as a marker for extensive inflammation in the context of myocardial ischemia.
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Tinhofer et al. (2025) studied this question.
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